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Arizona rates for HCPCS 90647

Haemophilus influenzae type b vaccine (Hib), PRP-OMP conjugate, 3 dose schedule, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $32.36 / $54.95
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $26.92 / $30.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $85.11 / $125.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $60.26 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $36.31 / $44.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $36.31 / $36.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $60.26 / $60.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $38.02 / $38.02